Could Norways mental health focus reduce incarceration in Michigan? – The Detroit News

Halden, Norway Fredrik Soerfjordmo sits at an Apple computer in a sun-filled print shop, designing artwork to be reproduced on a ceramic coffee mug.

In the past sixyears, the 30-year-old Norwegianhasearned a high school diploma, as well asdiplomas in photography, typography and digital tools. Soerfjordmosaid he also has gained insight into why he once stabbed a man to death.

"I've been going to a psychologist and psychiatrist and working on all of this so I can live with myself," he said. "All of this that I did is very far from where I am."

At Halden Prison in Norway, the guards carry no guns and the inmates have a considerable amount of freedom Karen Bouffard, The Detroit News

Soerfjordmois serving his sixth yearof a 15-year sentence at Halden Prison in Norway, which is considered the gold standard for the healthy rehabilitation of inmates. The recidivism rates in Michigan and Norway suggesthischances of remaining free after serving his sentence are greater than for inmates released from U.S. prisons.

Norway has gained an international reputation for effectively rehabilitating prisoners, while officialsin Michigan and across the country faceburgeoningjail populations and costs fueled significantly by the mentally ill.

Small elements of Michigan's criminal justice system reflectNorway's rehabilitative approach, from drug treatment courts to art and music therapy at afacility that treats the state's most severely mentally ill inmates. States such as North Dakota and Oregon have more aggressively changed how they handle prisoners based on the Norwegian system, hoping to improve treatment and reduce the number of repeat offenders.

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All of this that I did is very far from where I am.

The Detroit News recently visited Halden Prison, as well as mental health programs andpsychiatric hospitalsin Norway, to study the intersection of criminal justice and mental health in that country.Michigan has anincarceration rate that is more than eight times higher than Norway's, and the state is studying ways to reduce crowded jails.

Michigan's search for solutions comes as mass shootings across the country have cast a spotlight on mental health.

Critics arguethat failings in the United States' mental health system have turnedU.S. jails and prisons into revolving doors for people with mental illness a problem they say contributesto high incarceration rateswhile making some mentally ill prisoners sicker.They contendNorway, with a population about half of Michigan's nearly 10 million people, provides an example of how America and its states could better balance government spending between criminal justice and mental health services.

Norway spent $129,222 per prisoner in 2018 compared with $38,051spent per prisoner in Michigan, according to their respective government agencies. Federal prisons averaged $36,299 per inmate in 2017, the latest year available, according to the Federal Bureau of Prisons.

Norway spends more in part because its cost of living is higher than the United States'.But critics contend the United Statesspends more in the long run overall because its inmatesserve longer sentences and aremore likely to return to prison.

The exterior of Halden Prison.(Photo: HLM)

"Judges who are on the front lines see these people, (and) we believe we have a serious mental health population in our jails, and a population of people struggling with addiction," Michigan Supreme Court Chief JusticeBridget McCormack told The News.

"Its not clear that just putting them in jail and sending them back out is good for public safety."

McCormack and Lt. Gov. Garlin Gilchrist are leadinga Michigan Task Force on Jail and Pretrial Incarceration, createdin April to explore how to reduce populations at the state's county jails that have tripled since the mid-1980s even though crime is at a 50-year low.

Skeptics doubt thatNorwegian methodscouldwork in the United States.

"In Norway, the vast majority of the prisoners are going to all be Norwegian;theyre very much the same," said former Eaton County Sheriff Rick Jones, who served 14 years in the state Legislature before being term-limited out of office atthe end of2018.

"The United States is a melting pot, and we have many, many different cultures here," Jones said.

The presence of gangs as well as the mix of racesand cultures in prisons also tends to leadto more violence, Jones added.

Its not clear that just putting them in jail and sending them back out is good for public safety.

In the United States, black men were nearlysix times as likely to be incarcerated as white men in 2017, according to the U.S. Bureau of Justice Statistics. Blacks comprise 33% of the federal and state prison populations, while whites make up 30%.

In Norway, which has a population roughly the size of Minnesota's, more than 80% of the 5.3 million residents are ethnic Norwegians, including about 30,000 indigenousSamipeople. However, 30% of its prison population comes from other countries, primarily the Middle East and Eastern Europe.

Norway'smethods are being embraced by a growing number of American prison and criminal justice professionals.

"I think you have to see it to believe it," said North Dakota Corrections Director Leann Bertsch, who has twice visited Haldenand has adopted reforms based on the Norwegian model.

A stark differencein how U.S. and Norwegian officials approach mental health issues can be seen in Bergen, a coastal city in southwestNorway, where a mental health ambulance responds to calls relatedto mental health issues.

Works manager Janne Hasle stands in a light-filled corridor at Halden Prison in Norway, where inmates live in dorm-like rooms in three buildings on a campus filled with trees. (Photo: Adrian Ohrn Johansen, Special to The Detroit News)

Staffed on all runsby three psychiatric nurses and a driver with mental health training, they're skilled at calming distraught patients.If police are also on the scene, the mental health professionals take the lead.

In Michigan and the rest of the United States, police often havefirst contact with the mentally ill and decide which services they will receive. More than a quarter of Michigan's 38,000 state prison inmatesreceive mental health treatment, according to the state.

"Our jails and prisons have become the de facto psychiatric care facilities in this country," saidTom Watkins, the former president and CEO of the Detroit/Wayne County Mental Health Authorityand aformer state mental health director.

Michigan shouldadopt a version of Norway's system, said Washtenaw County Sheriff Jerry Clayton,who developed mandatorytwo-day mental health training for Washtenaw deputiesandpushed for acommunity mental health and public safety millage approvedby county voters in 2017.

Our jails and prisons have become the de facto psychiatric care facilities in this country.

"The police often are the focal point because of thedecisions that they make in those moments that result in people going to jail or going to a hospital, so the training is critical," Clayton said.

"We encourage people to call 911 if they need help," he said. "But what if you could call 211, and what if 211 linked up to that mental health ambulance or a mental health crisis team that could respond right away? ...I think its exactly another piece of what we need."

As in the United States, Norway has shuttered many of its mental institutions. But it has more than three times as many mental hospital beds per 100,000 residents as the United States. The state Department of Health and Human Services doesn't track how long patients must wait for admission to one of Michigan'sfive state-run mental hospitals, but 138people were on the waiting list at the end of September.

Lars Dahl, 40, sits in the chapel at Halden Prison in Norway. When they're ready, inmates in Norway are allowed to leave the prison for short excursions to a store or church. "I've tried to build up friendships outside with people who don't do drugs," he said. (Photo: Adrian Ohrn Johansen, Special to The Detroit News)

Norway has ahighly developed system of outpatient treatment and social supports to helpmentally ill people live independently. Access to substance abuse disordertreatment is no different than for any other mental health disorder.

Norway spent $693 per capita on mental health care in 2013, compared with $594 per capitain the United States, according to the Organization for Economic Development and Cooperation, the latest numbers available.

Mental health consumed 12%of Norway's total health spending, while7% of U.S. health care dollarswere spent on mental health care,according to the OEDC.

People who are addicted ormentally ill end up in jails and prisons in the United Statesbecause of "poor access (to) crisis response services in community settings,"said Leo Beletsky, a professor of law and health sciences and director of the Health in Justice Action Lab at Northeastern University.

(It) isnt just that weve under-invested in these services its also that our over-investment in policing, prosecutors and jails/prisons has directly crowded out investment in supportive structures across the board.

"But it isnt just that weve under-invested in these services its also that our over-investment in policing, prosecutorsand jails/prisons has directly crowded out investment in supportive structures across the board," Beletsky said.

As in the U.S., a high percentage of inmates in Norwegian prisonssuffer from depression, anxiety, personality disorders and other mental health issues. But their prison stays are likely to be shorter, and they're less likely to return after serving their time.

"I think all of the ideas and what theyre doing can be transferable to any system if theres the political will to do so," North Dakota's Bertsch said.

Mental heath care is provided by Norway's socialized health care system, andthe country has a well-developedinfrastructure for delivering mental health care. The United States relies more on private health insurance buttressed by government programs for the poor and seniors, and subsidized insurance.

Inmate Mike, who didn't give his last name, plays the drums at Halden Prison in Norway. He's from the Netherlands, and among 40 percent of Halden prisoners who come from foreign countries.(Photo: Adrian Ohrn Johansen, Special to The Detroit News)

Michigan's prisons, like most in the United States, are focused on security rather than rehabilitation.At state prisons, high school completion and vocational training programs are reserved for the inmates closest to their earliest release dates, saidChris Gautz, spokesman for the Michigan Department of Corrections.

By contrast, Norway views the primary purpose of incarceration asa successful return to the community, not punishment.

"The sentence is not the whole picture," said Jan R. Stromnes, deputy warden at Halden Prison. "It describes what they have done, but does not define them as a person.They are more than their criminal acts."

Experts including Watkins, the former Michigan mental health director, contend thatharsh conditions in U.S. prisons and jails exacerbatepoor mental health inmany inmates, setting them up for an endless cycle of imprisonment.

The sentence is not the whole picture. It describes what they have done, but does not define them as a person. They are more than their criminal acts.

Norwegians call their approach"restorative justice."

At Halden, Soerfjordmo has had time to reflect on his crime.In addition to psychotherapy,he attended a four-week cloistered retreat on the prison campus. Aided by priests and guidance counselors, he spenttime in prayer, meditation and contemplative reading.

"There was no talking, only at meals," Soerfjordmosaid. "You learn to appreciate the silence very much."

Under Norwegian law, the punishment for prisoners is the loss of freedom by being confined to a correctional facility.

The $250 million Halden Prison, which opened in 2010, wasdesigned to mimic life in a normal village. There are no steelbars, razor wire or watchtowers, though it's a maximum-security facility housingmurderers, rapists, child molesters and other dangerous criminals.

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The hilly75-acre site, located south of Oslo,is surrounded by a mile-long steel and concrete wall.While American prisons typically are stripped of vegetation due to security concerns, the grounds at Halden mirror the surrounding forested landscape.

Prisoners walk freely along asphalt paths lined with birch, pine and fruit trees to attend school and vocational programs, like culinary arts and auto mechanics..

Inmates live in individual dorm-like rooms.Each roomhasa large safety-glass window for a view of the park-like outdoors, as well as a comfortable bed, desk, mini-fridge and private bathroom with a shower.

"They can control their own lights. We have closed doors," Stromnes said."You should be able to go to the bathroom without everyone watching you."

Andre, 31, who preferred not to give his last name, is serving time for kidnapping and torturinga man. The crime was related to drug dealing, he said.He lives in a substance abuse treatment unit called "Navigator."

Prisoners are given an allowance to buy food from the prison store, which is stocked with fresh fruits and vegetables, meat and other groceries. One meal a week is provided for inmates. The rest they cook for themselvesor with others in their unit.

Vocational Officer Emelie Haale is seen in the crafts studio at Halden Prison in Norway. It's the first activity for new inmates. "Many will be surprised they can do something positive," Haale said.(Photo: Adrian Ohrn Johansen, Special to The Detroit News)

A big circle has been drawn on a whiteboard that hangs on the wall, divided into segments labeled with the Norwegian words for Independence, Freedom, Inner Calm, Happiness, Self-Mastery, Health, Purpose and Belonging.

These are goals the inmates are working toward, saidMonica Antila, one of two therapists in the Navigator unit.

"It's like a continuous dialogue," Andre said. "...My goal is not just to get out of prison, but not to come back."

There are no armed guards at Halden, though tear gas and weapons are locked away ifthey're needed. There are about 290 guards, administrators and other full-time personnelfor 260 inmates, plus 50 or so psychologists, nurses and other specialists imported from the surrounding community.

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Could Norways mental health focus reduce incarceration in Michigan? - The Detroit News